Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE SCREW CANC P/THD 4x14MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270668164
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

BONE SCREW CLAMP

Facility

$1,020.00

Hospital Charge Code	270339509
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

BONE SCREW CLAMP

Facility

$1,020.00

Hospital Charge Code	270339509
Hospital Revenue Code	278
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$32.23
Rate for Payer: Wellpoint Medicaid Managed Care	$28.97

BONE SCREW SELF TAP 3.5x20MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648601
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x20MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648601
Hospital Revenue Code	278
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$21.65
Rate for Payer: Wellpoint Medicaid Managed Care	$19.45

BONE SCREW SELF TAP 3.5x22MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270662027
Hospital Revenue Code	278
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$21.65
Rate for Payer: Wellpoint Medicaid Managed Care	$19.45

BONE SCREW SELF TAP 3.5x22MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270662027
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x34MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270673669
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x34MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270673669
Hospital Revenue Code	278
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$21.65
Rate for Payer: Wellpoint Medicaid Managed Care	$19.45

BONE SCREW T10 3.5MMXL28

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700424
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$191.57
Rate for Payer: Aetna Commercial	$145.60
Rate for Payer: Aetna Medicare Advantage	$114.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.70
Rate for Payer: Cigna Commercial	$191.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47
Rate for Payer: UnitedHealthcare Community & State	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$10.88

BONE SCREW T10 3.5MMXL28

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700424
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$92.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

BONE SCREW T10 3.5MMXL30

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700425
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$92.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

BONE SCREW T10 3.5MMXL30

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700425
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$191.57
Rate for Payer: Aetna Commercial	$145.60
Rate for Payer: Aetna Medicare Advantage	$114.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.70
Rate for Payer: Cigna Commercial	$191.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47
Rate for Payer: UnitedHealthcare Community & State	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$10.88

BONE SCREW T7 2.7x14MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673832
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T7 2.7x14MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673832
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

BONE SCREW T7 2.7x16MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673833
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T7 2.7x16MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673833
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

BONE SCREW T8 2.7MMXL38

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700422
Hospital Revenue Code	278
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$276.34
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08
Rate for Payer: UnitedHealthcare Community & State	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$20.65

BONE SCREW T8 2.7MMXL38

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700422
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

BONE SHAVER-MICRO HOOK

Facility

$2,225.00

Hospital Charge Code	270663202
Hospital Revenue Code	272
Min. Negotiated Rate	$63.19
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$845.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.50
Rate for Payer: Oxford Commercial	$445.00
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Commercial	$445.00
Rate for Payer: UnitedHealthcare Community & State	$70.31
Rate for Payer: Wellpoint Medicaid Managed Care	$63.19

BONE SHAVER-MICRO HOOK

Facility

$2,225.00

Hospital Charge Code	270663202
Hospital Revenue Code	272
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

BONE SOURCE 15CC 6184-0-250

Facility

$3,154.00

Hospital Charge Code	270335736
Hospital Revenue Code	278
Min. Negotiated Rate	$89.57
Max. Negotiated Rate	$1,577.00
Rate for Payer: Aetna Commercial	$1,198.52
Rate for Payer: Aetna Medicare Advantage	$946.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$804.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$804.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$804.27
Rate for Payer: Cigna Commercial	$1,577.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$763.27
Rate for Payer: Qualcare PPO/HMO/WC	$473.10
Rate for Payer: UnitedHealthcare Community & State	$99.67
Rate for Payer: Wellpoint Medicaid Managed Care	$89.57

BONE SOURCE 15CC 6184-0-250

Facility

$3,154.00

Hospital Charge Code	270335736
Hospital Revenue Code	278
Min. Negotiated Rate	$473.10
Max. Negotiated Rate	$763.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$763.27
Rate for Payer: Qualcare PPO/HMO/WC	$473.10

BONE SOURCE 3CC 6184-0-100

Facility

$735.00

Service Code	HCPCS C1762
Hospital Charge Code	270335734
Hospital Revenue Code	278
Min. Negotiated Rate	$20.87
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Community & State	$23.23
Rate for Payer: Wellpoint Medicaid Managed Care	$20.87

BONE SOURCE 3CC 6184-0-100

Facility

$735.00

Service Code	HCPCS C1762
Hospital Charge Code	270335734
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

Know your out-of-pocket cost for care.

All Charges